Non-participating lab referrals
This communication applies to the Medicare Advantage and Commercial programs from
Anthem Blue Cross and Blue Shield (Anthem) in Nevada.
This is a reminder to ensure that you are referring Anthem members to participating labs. LabCorp is our preferred lab provider and offers a single source solution to your testing needs. The relationship with LabCorp does not affect network hospital-based lab service providers, contracted pathologists, or contracted independent laboratories. Physicians may continue to refer to all par providers as they have in the past.
Not only does your Anthem agreement obligate you to refer to participating labs where available, but members will only receive their full benefits from participating providers. As a result, referring your patient and our member to a non-participating lab may expose them to a greater financial responsibility.
Unfortunately, there are certain non-participating labs that are offering to waive or cap co-payments, coinsurance, or deductibles to our members to increase their overall revenue. These practices undermine member benefits and may encourage over-utilization of services.
These billing practices are also questionable in their legality. Such a practice may present violations under state or federal anti-kickback laws.
For a listing of Anthem participating laboratories, please check our online directory. Go to anthem.com. Choose Select Providers, and Providers Overview. Select Find Resources in Your State and pick Nevada. From the Provider Home tab, select the enter button from the blue box on the left side of page titled Find a Doctor.
Note: When searching for laboratory, pathology, or radiology services, under the field I am looking for a:, select Lab/Pathology/Radiology, and then under the field Who specializes in:, select Laboratories, Pathology, or Radiology as appropriate for your inquiry.
LabCorp is our preferred lab provider and offers a single source solution to your testing needs.
LabCorp provides services that range from routine testing, such as basic blood counts and cholesterol tests, to highly complex diagnosing of genetic conditions, cancers, and other rare diseases. LabCorp has specialized laboratories which cover the following areas of testing:
· Allergy program
· Cancer testing
· Cardiovascular disease
· Companion diagnostics
· DNA testing
· Endocrine disorders
· Esoteric coagulation
· Genetic testing
· Genetic counseling
· Human Leukocyte Antigens (HLA) lab for national marrow donor program
· Infectious disease
· Liver disease
· Kidney disease
· Medical drug monitoring
· Molecular diagnostics
· Newborn screening
· Pain management
· Pathology expertise with range of subspecialties
· Preimplantation genetic diagnosis
· Reproductive health
· Obstetrics/ gynecology
· Whole exome sequencing
· Women’s health
Note: This relationship with LabCorp does not affect network hospital-based lab service providers, or contracted pathologists.
To find a LabCorp location near you, go to www.LabCorp.com or call one of the phone numbers below.
For information about specialized assays or about requirements for special collection kits and specimen handling, call LabCorp at 303-792-2600 or toll free at 888-LABCORP (888-522-2677).
July 2022 Anthem Provider News - Nevada